This application proposes the development of broadly based, multi- disciplinary health services research training program designed to provide trainees the skills necessary to meet the rapidly changing demands of the health care systems. The overall goal is to create a rigorous but flexible training program in health services research that can provide the knowledge, skills and experiences that are appropriate for several different levels of participation and future needs of the trainees. The program will provide opportunities for a diverse set of participants, from the medical director of a health care plan who desires to understand basic concepts of outcomes research and cost- effectiveness analysis to an academic physician actively engaged in clinical health services research. The core of this innovative health services research training program at the University of Pittsburgh School of Medicine will be the development of a certificate program in Clinical Effectiveness/ Evaluation Sciences. This program will combine the faculty, resources and research efforts of the Division of General Medicine, the Center for Research on Health Care, and the Graduate School of Public Health to create a research training program that 1)provides survey courses and introductory-level opportunities for fellows, junior faculty and researchers from many departments and disciplines as well as from various non-academic health care settings to become familiar with health services research methods, 2) provides coordinated, rigorous basic training in health services research for investigators who seek to utilize these methods in their research efforts; 3)provides research experiences in academic and non-academic settings (e.g. health plans, integrated delivery systems, and managed care group practices); 4)forms the foundation for clinicians who wish to earn a master's degree in public health with a concentration in health services research; and 5) enhances the subject offerings in health services research training. The outcome of this program will be an outstanding health services research training program for general medicine fellows as well as greatly expanding the pool of physicians who will receive training in health services research. Ultimately, the intent of the program is to increase the capacity for conducting of health services research studies at the University of Pittsburgh and the region.